Oral Manifestation of Stevens-Johnson Syndrome: a Case Report

Stevens-Johnson syndrome (SJS), a rare dermatological condition, affects the skin and mucosa, and is usually triggered by medications and rarely by infections. A 17-year-old boy presented with oral and ocular mucosal pain. Clinical examination revealed erosive areas with epithelial detachment in the oral cavity, lip ulceration, conjunctival hyperemia, and fever. The patient reported tetracycline use for 30 days to treat acne. The diagnostic hypotheses were SJS, Behçet's disease, and viral infection. The clinical condition of the patient worsened, despite the tetracycline suspension, with maculopapular lesions in the thorax, dorsum, and upper limbs, and an increase of the previous injuries. Serological tests were negative for hepatitis, HIV, toxoplasmosis, CMV, herpes, and syphilis. An incisional biopsy of the arm lesion and histopathological examination showed vacuolar interface dermatitis with subtotal epidermal necrosis. Treatment included systemic hydrocortisone and prednisone, local hygiene care, and low-level laser therapy of the oral lesions; all the lesions exhibited remission.